On 28 April 2017, Ian Paterson was convicted of intentionally wounding patients. Here, Charlie Massey, Chief Executive of the GMC, asks how we can all contribute to prevent this from happening again.
The crimes of which Ian Paterson has been convicted were deeply shocking acts that betrayed patients’ trust. Every expectation we have of those we entrust with our health was violated by his actions.
It is absolutely right that questions are asked about how this happened and more crucially how we can prevent it from happening again. Some though have tried to characterise these events as a failure of revalidation and that is wrong.
Sadly revalidation did not exist when Ian Paterson was committing his terrible acts. His crimes took place in the years before revalidation was introduced in 2012, when doctors’ appraisals were at times woefully inadequate.
His practice went unchecked because some of those in the health system – managers but also his colleagues – had their concerns but failed to report them to the GMC. It took referrals by patients in late 2010 to bring Paterson’s behaviour to our attention, whereupon we launched an investigation, suspended him from practice and referred him to the police.
The model of medical regulation in place before 2012 meant that, unless serious concerns came to light about them, a doctor could practise from registration to retirement without any real checks on their competence, performance or behaviour. I don’t believe that is something which good doctors or their patients would consider acceptable in this day and age.
If a doctor with a working pattern like Ian Paterson was practising now they would have a Responsible Officer, who would make sure they had an annual appraisal covering both their NHS and private work, taking into account feedback from patients and colleagues, an analysis of any complaints and evidence demonstrating the quality of their work. That Responsible Officer, a senior doctor bound to uphold our professional standards like any other, could only recommend that doctor for revalidation if there were no outstanding concerns about their practice.
The culture of healthcare is different to what it was in the last decade – not perfect by any means, but we have made progress. Concerns about doctors are picked up and managed, rather than swept under the carpet – thanks in large part to the arrival of Responsible Officers as well as our network of employer liaison advisers who have regular conversations with them to help catch concerns early.
Each of us is ‘responsible’ though for protecting patients. Anyone who witnesses poor care must stand up and do something about it. If everyone plays their part, then the new ‘safety net’ – made up of revalidation, Responsible Officers and more rigorous appraisals – can and should stop another doctor like Ian Paterson from harming patients in the future.
If you need to raise a concern about a doctor, please contact us.